BackgroundStress urinary incontinence (SUI) leads to considerable physical and psychological morbidity. The highest prevalence reported was found in Caucasian Americans (range 23% -67%) and the lowest in Singaporean females (4.8%). The study assessed the prevalence, perceptions, predisposing factors and health seeking behaviour of women with SUI in an Asian setting which may have different sociocultural implications.Methods400 consecutive women >20 years of age attending the outpatient department of a tertiary care hospital in Sri Lanka, for non-urinary conditions were studied over a 3 week period using an interviewer administered questionnaire. SUI was diagnosed on clinical history alone when leakage of urine occurred either with coughing, sneezing, walking or lifting heavy objects. The severity was graded using the Finnish Gynaecological Society’s Urinary Incontinence Severity Score (UISS). Data were analysed using SPSS version 20. Odds ratios were calculated using univariate and multivariate analysis.ResultsNinety three (23.33%) had SUI and only 12 (12.9%) had sought treatment. The prevalence among women >50 years of age was 34.71% ( n = 121) compared to 18.28% (n = 279) in those ≤50 years. 25 (26.88%) had mild SUI, 66 (70.97%) moderate and 2 (2.15%) severe as per UISS. SUI was perceived as an illness by 210 (52.5%). SUI was significantly associated with pregnancy, parity, vaginal delivery, complicated labour, diabetes mellitus, chronic cough, constipation and faecal incontinence (p < 0.05).Among those affected main reasons for not seeking medical advice included; being embarrassed (n = 27, 33.33%), not knowing that it is remediable (n = 23, 28.40%), perceiving SUI to be a normal consequence of childbirth (n = 19, 23.46%) and having to attend to needs of the family (n = 12, 14.81%). None who had been pregnant (n = 313) had received advice on postnatal pelvic floor exercises. SUI interfered with social activities (71;76.34%), sexual function (21; 22.58%) and resulted in despair (67; 72.09%). It was associated with clinically diagnosed candidiasis (50; 53.76%) and soreness in the perineal region (49; 52.69%).ConclusionsSUI is a common and neglected gynaecological problem with poor healthcare seeking behaviour. Community based education may help to minimize the occurrence and improve the quality of life of those affected.

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a b s t r a c tBackground: Rigid bronchoscopy is an invasive procedure that requires general anaesthesia with different ventilation strategies. Various mechanical and systemic complications can arise from the procedure and anaesthetic technique employed. The aim of this study is to evaluate the two common anaesthetic techniques and the peri-interventional morbidity of rigid bronchoscopy. Methods: We retrospectively analysed all the rigid bronchoscopies conducted in Singapore General Hospital between 1999 and 2014. Patient characteristics, type of procedures, type of anaesthesia, duration of procedure, ventilation strategies, various intra-operative medications, pre-operative and postoperative arterial blood gas, oxygen saturation and pulmonary function test, and peri-interventional complications were collected. Continuous data were reported as mean and categorical data were reported as percentages. Results: Majority of patients that underwent rigid bronchoscopy received total intravenous anaesthesia (81%). A significantly higher proportion of patients in the volatile groups were scheduled for biopsy (29.4%) using rigid bronchoscopy. Choice of ventilation strategies were largely similar in both groups. A higher complication rate of hypertension (11.8%), acute myocardial infarction (11.8%) and pneumothorax (17.6%) was seen in the volatile group. Conclusion: The choice of anaesthetic technique possibly affects the complication of patients undergoing rigid bronchoscopy. Volatile anaesthetics appeared to be driven by presumably shorter procedure, but was associated with higher systemic complication.